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63 Cards in this Set
- Front
- Back
- 3rd side (hint)
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What are the two types of partial seizures
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Simple and complex
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What are the three types of general seizures
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Tonic-clonic, absence, and myoclonic
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What is another name for tonic-clonic seizures
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Grand mal seizures
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What is another name for absence seizures
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Petit mal seizures
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Does hypoventilation or hyperventilation lower the seizure threshold
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Hyperventialtion (via alkalinization of blood pH)
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What is the most common seizure type
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Tonic-clonic seizure
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What type of seizure is associated with “febrile seizures”
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Tonic-clonic seizure
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What type of seizure most commonly presents during childhood
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Absence seizure
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What is status epilepticus
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Epileptic seizure lasting longer than 30 minutes or absence of full recovery of consciousness between seizures (can be life threatening)
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In general, how do antiepileptic agents work
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Inhibit initiation of an abnormal electrical discharge from the focal area; prevent dissemination of abnormal electrical discharge to surrounding areas of the brain
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What is the mechanism of action of phenytoin
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Inhibition of axonal sodium channels to produce membrane stabilization
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Does phenytoin inhibit the axonal sodium channel in its activated or inactivated state
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Inactivated state
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What antiarrhythmic class does phenytoin belong to
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Class Ib
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What type of drug interactions can phenytoin produce
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Induces cytochrome P-450 metabolic enzymes; highly protein bound, therefore, can potentially displace other medications from plasma proteins
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What are the adverse effects of phenytoin
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Diplopia
Sedation Ataxia Gingival hyperplasia Acne Hirsutism Megaloblastic anemia (interferes with folate absorption) Granulocytopenia Hypotension (IV) Osteomalacia Drug-induced lupus Hyperglycemia Nystagmus Stevens-Johnson syndrome Hepatotoxicity |
None
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Is phenytoin safe to use during pregnancy
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No (causes fetal hydantoin syndrome characterized by cleft lip and palate)
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What prodrug is hydrolyzed to phenytoin and is commonly given intravenously secondary to its superior water solubility vs. phenytoin
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Fosphenytoin
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What is the acronym for phenytoin
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DPH (diphenyl hydantoin)
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Name two other medications that may cause gingival hyperplasia
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Cyclosporin A
Nifedipine |
None
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Which types of seizures does phenytoin treat
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Partial
Tonic-clonic Status epilepticus |
None
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What is the mechanism of action of carbamazepine
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Inhibition of axonal sodium channels to produce membrane stabilization
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What type of drug interactions can carbamazepine cause
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Induces cytochrome P-450 metabolic enzymes
Autoinduces its own metabolism |
None
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What conditions, other than epilepsy, can carbamazepine be used in
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Manic-depression
Trigeminal neuralgia |
None
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What are the adverse effects of carbamazepine
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Diplopia
Sedation Ataxia Osteomalacia Aplastic anemia Hyponatremia Stevens-Johnson syndrome Alopecia Pancreatitis Hepatotoxicity Nystagmus |
None
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Is carbamazepine safe to use in pregnancy
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No (neural tube defects and craniofacial abnormalities)
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None
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How does carbamazepine cause hyponatremia
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Syndrome of inappropriate antidiuretic hormone
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Which types of seizures does carbamazepine treat
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Tonic-clonic
Simple partial Complex partial |
None
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What antiepileptic medication can cause alopecia
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Valproic acid (VPA)
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What is the mechanism of action of valproic acid (VPA)
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Inhibition of axonal sodium channels
Inhibition of T-type calcium channels Inhibition of GABA transaminase |
None
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What type of drug interactions can VPA produce
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Inhibition of cytochrome P-450 enzymes
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What conditions, other than epilepsy, can VPA be used in
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Manic-depression
Migraine |
None
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What are the adverse effects of VPA
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Hepatotoxicity
Pancreatitis Alopecia Nausea Vomiting Photosensitivity Sedation Diarrhea Abdominal pain Thrombocytopenia Rash Amenorrhea Dysmenorrhea Weight gain Tinnitus |
None
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Is VPA safe to use in pregnancy
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No (neural tube defects)
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Which types of seizures does VPA treat
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Tonic-clonic
Simple partial Complex partial Absence Myoclonic |
None
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Which antiepileptic medication is used to treat partial and tonic-clonic seizures during pregnancy
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Phenobarbital
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Phenobarbital is an active metabolite of which medication
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Primidone
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What is the second active metabolite of primidone
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Phenylethylmalonamide (PEMA)
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Which benzodiazepines are used in the treatment of status epilepticus
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Diazepam; Lorazepam
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Which benzodiazepine is used to treat myoclonic and absence seizures
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Clonazepam
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Which antiepileptic medication is the drug of choice for treating absence seizures and its only FDA indication is for absence seizures
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Ethosuximide
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What is the mechanism of action of ethosuximide
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Inhibition of T-type calcium channels in the thalamus
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What are the adverse effects of ethosuximide
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EPS
Nausea Vomiting Diarrhea Abdominal pain Fatigue Hirsutism Stevens-Johnson syndrome Drug-induced lupus Hiccups |
None
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What medication may be used to treat intractable hiccups
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Chlorpromazine (antipsychotic)
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None
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Which antiepileptics decrease the efficacy of oral contraceptives
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Phenytoin; Carbamazepine
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How do phenytoin and carbamazepine decrease the efficacy of oral contraceptives
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Induction of cytochrome P-450 enzymes
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Overdose or abrupt withdrawal of antiepileptics may cause what adverse effect
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Seizures
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Give examples of antiepileptic medications
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Phenytoin
Carbamazepine Oxcarbazepine Phenobarbital Gabapentin Tiagabine Levetiracetam Felbamate Ethosuximide Valproic acid Lamotrigine Topiramate Zonisamide Lorazepam Diazepam Fosphenytoin Vigabatrin Corticotropin Prednisone |
None
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Name two antiepileptics that are considered free of drug-drug interactions
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Gabapentin
Levetiracetam |
None
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Which of the newer antiepileptics may inhibit carbonic anhydrase thereby causing a metabolic acidosis
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Topiramate
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What conditions, other than epilepsy, can topiramate be used in
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Migraine
Manic-depression Neuropathic pain |
None
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What is the mechanism of action of topiramate
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Inhibition of glutamate (AMPA) receptors
Increases GABA effects Blocks neuronal voltage-gated sodium channels |
None
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Which types of seizures does topiramate treat
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Partial
Seizures associated with Lennox-Gastaut syndrome |
None
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What are the adverse effects of topiramate
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Impaired cognition
Word finding difficulty Sedation Weight loss Renal stones Metabolic acidosis |
None
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Which of the newer antiepileptics may cause Stevens-Johnson syndrome
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Lamotrigine
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What is the mechanism of action of lamotrigine
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Inhibition of sodium channels
Inhibition of glutamate receptors |
None
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Which types of seizures does lamotrigine treat
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Partial
Absence Seizures associated with Lennox-Gastaut syndrome |
None
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What are the adverse effects of lamotrigine
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Stevens-Johnson syndrome
Sedation Headache Dizziness Ataxia Nausea Diplopia Amenorrhea Dysmenorrhea |
None
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What neurotransmitter is gabapentin structurally related to
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GABA
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Does gabapentin bind to the GABA receptor
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No
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What is the mechanism of action of gabapentin
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Unknown (may bind to voltage-gated calcium channels specifically possessing the α-2-δ-1 subunit)
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Which types of seizures does gabapentin treat
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Partial
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None
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What conditions, other than epilepsy, can gabapentin be used in
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Neuropathic pain
Anxiety Migraine Trigeminal Neuralgia |
None
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What are the adverse effects of gabapentin
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Peripheral edema
Behavioral and thought disorders in children aged 3-12 Sedation Ataxia Viral infection (in children) Weight gain Diarrhea Nausea Vomiting |
None
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